[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3519 Referred in Senate (RFS)]
2d Session
H. R. 3519
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 16, 2000
Received; read twice and referred to the Committee on Foreign Relations
_______________________________________________________________________
AN ACT
To provide for negotiations for the creation of a trust fund to be
administered by the International Bank for Reconstruction and
Development or the International Development Association to combat the
AIDS epidemic.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``World Bank AIDS Marshall Plan Trust
Fund Act''.
SEC. 2. FINDINGS AND PURPOSES.
(a) Findings.--The Congress finds the following:
(1) According to the Surgeon General of the United States,
the epidemic of human immunodeficiency virus/acquired immune
deficiency syndrome (HIV/AIDS) will soon become the worst
epidemic of infectious disease in recorded history, eclipsing
both the bubonic plague of the 1300's and the influenza
epidemic of 1918-1919 which killed more than 20,000,000 people
worldwide.
(2) According to the Joint United Nations Programme on HIV/
AIDS (UNAIDS), 33,600,000 people in the world today are living
with HIV/AIDS, of which approximately 95 percent live in the
developing world.
(3) UNAIDS data shows that among children age 14 and under
worldwide, 3,600,000 have died from AIDS, 1,200,000 are living
with the disease; and in one year alone--1999--an estimated
570,000 became infected, of which over 90 percent were babies
born to HIV-positive women.
(4) Although sub-Saharan Africa has only 10 percent of the
world's population, it is home to 23,300,000--roughly 70
percent--of the world's HIV/AIDS cases.
(5) Worldwide, there have already been an estimated
16,300,000 deaths because of HIV/AIDS, of which 13,700,000--
over 80 percent--occurred in sub-Saharan Africa.
(6) According to testimony by the Office of National AIDS
Policy, an entire generation of children in Africa is in
jeopardy, with one-fifth to one-third of all children in some
countries already orphaned and the figure estimated to rise to
40,000,000 by 2010.
(7) The 1999 annual report by the United Nations Children's
Fund (UNICEF) states ``[t]he number of orphans, particularly in
Africa, constitutes nothing less than an emergency, requiring
an emergency response'' and that ``finding the resources needed
to help stabilize the crisis and protect children is a priority
that requires urgent action from the international
community.''.
(8) A 1999 Bureau of the Census report states that the
average life expectancy in the Republic of Botswana, the
Republic of Zimbabwe, the Kingdom of Swaziland, the Republic of
Malawi, and the Republic of Zambia has decreased from
approximately age 65 to approximately age 40--the lowest life
expectancy in the world--due to high mortality rates from HIV/
AIDS.
(9) A January 2000 unclassified United States National
Intelligence Estimate (NIE) report on the global infectious
disease threat concluded that the economic costs of infectious
diseases--especially HIV/AIDS--are already significant and
could reduce GDP by as much as 20 percent or more by 2010 in
some sub-Saharan African nations.
(10) According to the same NIE report, HIV prevalence among
militias in Angola and the Democratic Republic of the Congo are
estimated at 40 to 60 percent, and at 15 to 30 percent in
Tanzania.
(11) The HIV/AIDS epidemic is of increasing concern in
other regions of the world with UNAIDS reporting, for example,
that there are 6 million cases in South and South-east Asia,
that the rate of HIV infection in the Caribbean is second only
to sub-Saharan Africa, and that HIV infections have doubled in
just two years in the former Soviet Union.
(12) Despite the grim statistics on the spread of HIV/AIDS,
some developing nations--such as Uganda, Senegal, and
Thailand--have implemented prevention programs that have
substantially curbed the rate of HIV infection.
(13) AIDS, like all diseases, knows no boundaries, and
there is no certitude that the scale of the problem in one
continent can be contained within that region.
(14) According to a 1999 study prepared by UNAIDS and the
Francois-Xavier Bagnoud Center for Health and Human Rights at
the Harvard School of Public Health, HIV/AIDS is spreading
three times faster than funding available to control the
disease.
(15) The United Nations Secretary General has stated ``[n]o
company and no government can take on the challenge of AIDS
alone,'' and that ``what is needed is a new approach to public
health--combining all available resources, public and private,
local and global.''.
(16) The World Bank, declaring AIDS not just a public
health problem but ``the foremost and fastest-growing threat to
development'' in Africa, has launched a new strategy for HIV/
AIDS in Africa, declaring it a top priority for the Bank on
that continent.
(17) The World Bank estimates that for Africa alone
$1,000,000,000 to $2,300,000,000 annually is needed for
prevention in contrast to the approximately $300,000,000 a year
in official assistance currently available for HIV/AIDS in
Africa.
(18) Accordingly, United States financial support for
medical research, education, and disease containment as a
global strategy has beneficial ramifications for millions of
Americans and their families who are affected by this disease,
and the entire population which is potentially susceptible.
(b) Purposes.--The purposes of this Act are to prevent the spread
of HIV/AIDS and promote its eradication, prevent human suffering, and
to mitigate the devastating impact of the disease on economic and human
development, social stability, and security in the developing world,
through the creation of a trust fund which is designed to--
(1) work with governments, civil society, non-governmental
organizations, the Joint United Nations Program on HIV/AIDS
(UNAIDS), the International Partnership Against AIDS in Africa,
other international organizations, donor agencies, and the
private sector to intensify action against the HIV/AIDS
epidemic and to support essential field work in the most
affected countries to assist in the development of AIDS
vaccines; and
(2) seek to leverage financial commitments by the United
States in order to mobilize additional resources from other
donors, the private sector, nongovernmental organizations, and
recipient countries to combat the spread of HIV/AIDS.
TITLE I--NEGOTIATIONS FOR THE CREATION OF A WORLD BANK AIDS TRUST FUND
SEC. 101. TRUST FUND TO ASSIST IN HIV/AIDS PREVENTION, CARE AND
TREATMENT, AND ERADICATION.
The Secretary of the Treasury shall seek to enter into negotiations
with the International Bank for Reconstruction and Development or the
International Development Association, and with the member nations of
such institutions and with other interested parties for the creation of
a trust fund which would be authorized to solicit and accept
contributions from governments, the private sector, and nongovernmental
entities of all kinds and use the contributions to address the HIV/AIDS
epidemic in countries eligible to borrow from such institutions, as
follows:
(1) Program objectives.--The trust fund would provide only
grants, including grants for technical assistance, to support
measures to build local capacity in national and local
government, civil society, and the private sector to lead and
implement effective and affordable HIV/AIDS prevention,
education, treatment and care services, and research and
development activities, including affordable drugs. Among the
activities the trust fund would provide grants for would be
programs to promote best practices in prevention, including
health education messages that emphasize risk avoidance;
measures to ensure a safe blood supply; voluntary HIV/AIDS
testing and counseling; measures to stop mother-to-child
transmission of HIV/AIDS, including through diagnosis of
pregnant women, access to cost-effective treatment and
counseling and access to infant formula or other alternatives
for infant feeding; and deterrence of gender-based violence and
provision of post-exposure prophylaxis to victims of rape and
sexual assault. In carrying out these objectives, the trust
fund would coordinate its activities with governments, civil
society, nongovernmental organizations, the Joint United
Nations Program on HIV/AIDS (UNAIDS), the International
Partnership Against AIDS in Africa, other international
organizations, the private sector, and donor agencies working
to combat the HIV/AIDS crisis.
(2) Priority.--In providing such grants, the trust fund
would give priority to countries that have the highest HIV/AIDS
prevalence rate or are at risk of having a high HIV/AIDS
prevalence rate, and that have or agree to carry out a national
HIV/AIDS program which--
(A) has a government commitment at the highest
level and multiple partnerships with civil society and
the private sector;
(B) invests early in effective prevention efforts;
(C) requires cooperation and collaboration among
many different groups and sectors, including those who
are most affected by the epidemic, religious and
community leaders, nongovernmental organizations,
researchers and health professionals, and the private
sector;
(D) is decentralized and uses participatory
approaches to bring prevention care programs to
national scale; and
(E) is characterized by community participation in
government policymaking as well as design and
implementation of the program, including implementation
of such programs by people living with HIV/AIDS,
nongovernmental organizations, civil society, and the
private sector.
(3) Governance.--
(A) In general.--The trust fund would be
administered as a trust fund of the International Bank
for Reconstruction and Development. Subject to general
policy guidance from the President of the United States
and representatives of the other donors to the trust
fund, the Trustee would be responsible for managing the
day-to-day operations of the trust fund.
(B) Selection of projects and recipients.--In
consultation with the President and other donors to the
trust fund, the Trustee would establish criteria, that
have been agreed on by the donors, for the selection of
projects to receive support from the trust fund,
standards and criteria regarding qualifications of
recipients of such support, as well as such rules and
procedures as would be necessary for cost-effective
management of the trust fund. The trust fund would not
make grants for the purpose of project development
associated with bilateral or multilateral development
bank loans.
(C) Transparency of operations.--The Trustee shall
ensure full and prompt public disclosure of the
proposed objectives, financial organization, and
operations of the trust fund.
(D) Advisory board.--
(i) Appointment.--The President of the
United States and representatives of other
participating donors to the trust fund would
establish an Advisory Board, and appoint to the
Advisory Board renowned and distinguished
international leaders who have demonstrated
integrity and knowledge of issues relating to
development, health care (especially HIV/AIDS),
and Africa.
(ii) Duties.--The Advisory Board would, in
consultation with other international experts
in related fields (including scientists,
researchers, and doctors), advise and provide
guidance for the trust fund on the development
and implementation of the projects receiving
support from the trust fund. Once the Advisory
Board is established, the Secretary of the
Treasury shall ensure that the Trustee provides
the Advisory Board complete access to all
information and documents of the trust fund
necessary to the effective functioning of the
Advisory Board.
TITLE II--UNITED STATES FINANCIAL PARTICIPATION
SEC. 201. LIMITATIONS ON AUTHORIZATION OF APPROPRIATIONS.
In addition to any other funds authorized to be appropriated for
multilateral or bilateral programs related to AIDS or economic
development, there are authorized to be appropriated to the Secretary
of the Treasury $100,000,000 for each of fiscal years 2001 through 2005
for payment to the trust fund established as a result of negotiations
entered into pursuant to section 101.
TITLE III--REPORTS
SEC. 301. REPORTS TO THE CONGRESS.
(a) Annual Reports.--Not later than 1 year after the date of the
enactment of this Act, and annually thereafter for the duration of the
trust fund established pursuant to section 101, the Secretary of the
Treasury shall submit to the appropriate committees of the Congress a
written report on the trust fund, the goals of the trust fund, the
programs, projects, and activities, including any vaccination
approaches, supported by the trust fund, and the effectiveness of such
programs, projects, and activities in reducing the worldwide spread of
AIDS.
(b) Appropriate Committees Defined.--In subsection (a), the term
``appropriate committees'' means the Committees on Appropriations, on
International Relations, and on Banking and Financial Services of the
House of Representatives and the Committees on Appropriations, on
Foreign Relations, and on Banking, Housing, and Urban Affairs of the
Senate.
TITLE IV--HIV/AIDS PREVENTION AND CARE
SEC. 401. STRENGTHENING LOCAL CAPACITY IN SUB-SAHARAN AFRICA TO
IMPLEMENT HIV/AIDS PREVENTION AND CARE PROGRAMS.
Title XVI of the International Financial Institutions Act (22
U.S.C. 262p--262p-7) is amended by adding at the end the following:
``SEC. 1625. STRENGTHENING LOCAL CAPACITY IN SUB-SAHARAN AFRICA TO
IMPLEMENT HIV/AIDS PREVENTION AND CARE PROGRAMS.
``The Secretary of the Treasury shall instruct the United States
Executive Director at the International Bank for Reconstruction and
Development to use the voice and vote of the United States to encourage
the Bank to work with sub-Saharan African countries to modify projects
financed by the Bank and develop new projects to build local capacity
to manage and implement programs for the prevention of human
immunodeficiency virus (HIV) and acquired immune deficiency syndrome
(AIDS) and the care of persons with HIV/AIDS, including through health
care delivery mechanisms which facilitate the distribution of
affordable drugs for persons infected with HIV.''.
Passed the House of Representatives May 15, 2000.
Attest:
JEFF TRANDAHL,
Clerk.